IS PATIENT SAFETY AT THE HEART OF MEDICAL EDUCATION IN INDONESIA? REFLECTION ON THE IMPACT OF THE NATIONAL EXAMINATION

ABSTRACT Background: National examinations in Indonesia (UKMPPD) has been implemented since 2007 as a quality assurance method for medical graduates and medical schools. The impact of UKMPPD has been studied since then, where one of the consequences were related to how it affected medical education and curricula. This study explored the consequences of UKMPPD, focusing on how the students, teachers, and medical schools’ leaders relate the examination with patient care. This study aimed to explore the impact of UKMPPD on medical education, which focusing on the issue of patient safety. Methods: This study was part of a doctoral project, using a qualitative method with a modified grounded theory approach. The perspectives of multiple stakeholders on the impact of the UKMPPD were explored using interview and focus groups. Interviews were conducted with medical schools’ representatives (vice deans/ programme directors), while focus groups were conducted with teachers and students. A sampling framework was used by considering the characteristics of Indonesian medical schools based on region, accreditation status, and ownership (public/ private). Data was analysed using open coding and thematic framework as part of the iterative process. Results: The UKMPPD affected how the stakeholders viewed this high-stakes examination and the education delivered in their medical schools. One of the consequences revealed how stakeholders viewed the UKMPPD and its impact on patient care. Participants viewed the UKMPPD as a method of preparation for graduates’ real clinical practice. The lack of reference for patient safety as the impact of the UKMPPD in this study showed that there were missing links in how stakeholders perceived the examination as part of quality assurance in health care. Conclusion: The UKMPPD as a high-stakes examination has a powerful impact in changing educational policy and programmes in Indonesia. However, in Indonesia, the examination brought in the reflection on how the “patient” element was lacking from medical education. This research offers an insight on the concept of patient safety in Indonesia and how the stakeholders could approach the issue. Keywords: UKMPPD, national licensing examination, impact, competence, patient safety, curriculum

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59. General medicine residents' perception of the mini-CEXs

Clinical & Investigative Medicine ◽

10.25011/cim.v30i4.2820 ◽

2007 ◽

Vol 30 (4) ◽

pp. 61

Author(s):

S. Malhotra ◽

R. Hatala ◽

C.-A. Courneya

Keyword(s):

Internal Medicine ◽

Medical Education ◽

Focus Group ◽

Qualitative Study ◽

Focus Groups ◽

General Medicine ◽

Clinical History ◽

Phenomenological Approach ◽

Medical Teacher ◽

The Impact

The mini-CEX is a 30 minute observed clinical encounter. It can be done in the outpatient, inpatient or emergency room setting. It strives to look at several parameters including a clinical history, physical, professionalism and overall clinical competence. Trainees are rated using a 9-point scoring system: 1-3 unsatisfactory, 4-6 satisfactory and 7-9 superior. Eight months after the introduction of the mini-CEX to the core University of British Columbia Internal Medicine Residents, a one hour semi-structured focus group for residents in each of the three years took place. The focus groups were conducted by an independent moderator, audio-recorded and transcribed. Using a phenomenological approach the comments made by the focus groups participants were read independently by three authors, organized into major themes. In doing so, several intriguing common patterns were revealed on how General Medicine Residents perceive their experience in completing a mini-CEX. The themes include Education, Assessment and Preparation for the Royal College of Physicians and Surgeons Internal Medicine exam. Resident learners perceived that the mini-CEX process provided insight into their clinical strengths and weaknesses. Focus group participants favored that the mini-CEX experience will benefit them in preparation, and successful completion of their licensing exam. Daelmans HE, Overmeer RM, van der Hem-Stockroos HH, Scherpbier AJ, Stehouwer CD, van der Vleuten CP. In-training assessment: qualitative study of effects on supervision and feedback in an undergraduate clinical rotation. Medical Education 2006; 40(1):51-8. De Lima AA, Henquin R, Thierer J, Paulin J, Lamari S, Belcastro F, Van der Vleuten CPM. A qualitative study of the impact on learning of the mini clinical evaluation exercise in postgraduate training. Medical Teacher January 2005; 27(1):46-52. DiCicco-Bloom B, Crabtree BF. The Qualitative Research Interview. Medical Education 2006; 40:314-32.

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Web-based Medical Education During COVID-19 Lockdown: A Step Back or a Leap to the Future?

The International Journal of Lower Extremity Wounds ◽

10.1177/15347346211011848 ◽

2021 ◽

pp. 153473462110118

Author(s):

Anna Eleftheriou ◽

Aikaterini Rokou ◽

Christos Argyriou ◽

Nikolaos Papanas ◽

George S. Georgiadis

Keyword(s):

Medical Education ◽

Clinical Training ◽

Medical Training ◽

Medical Schools ◽

Web Based ◽

Clinical Exposure ◽

Virtual Teaching ◽

Based Medicine ◽

The Impact

The impact of coronavirus infectious disease (COVID-19) on medical education has been substantial. Medical students require considerable clinical exposure. However, due to the risk of COVID-19, the majority of medical schools globally have discontinued their normal activities. The strengths of virtual teaching now include a variety of web-based resources. New interactive forms of virtual teaching are being developed to enable students to interact with patients from their homes. Conversely, students have received decreased clinical training in certain medical and surgical specialities, which may, in turn, reduce their performance, confidence, and abilities as future physicians. We sought to analyze the effect of telemedicine on the quality of medical education in this new emerging era and highlight the benefits and drawbacks of web-based medical training in building up future physicians. The COVID-19 pandemic has posed an unparalleled challenge to medical schools, which are aiming to deliver quality education to students virtually, balancing between evidence-based and experience-based medicine.

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The Mandate Project: Institutionalizing a System of Patient Care Quality Assurance

PEDIATRICS ◽

10.1542/peds.57.5.775 ◽

1976 ◽

Vol 57 (5) ◽

pp. 775-782

Author(s):

Daniel S. Fleisher ◽

Clement R. Brown ◽

Carter Zeleznik ◽

Gerald H. Escovitz ◽

Charles Omdal

Keyword(s):

Medical Education ◽

Quality Assurance ◽

Patient Care ◽

Psychosocial Factors ◽

Continuing Medical Education ◽

Care Quality ◽

Quality Assurance Program ◽

Patient Care Quality

In 1970, prior to present-day requirements for quality assurance programs, a project was undertaken to institute such a program voluntarily in ten hospitals. Five hospitals succeeded in fully implementing the program which was based on the "Bi-Cycle Process" and each documented improvements in desired patient care behaviors. Two hospitals partially implemented the process and demonstrated no significant changes in desired patient care behaviors. Two hospitals failed to provide the data upon which assessments could be made and one hospital never got beyond preliminary efforts at instituting the process. The project demonstrates that a voluntary quality assurance program is feasible and has important implications for PSROs and continuing medical education. It also provides evidence that attention to psychosocial factors is essential in the institutionalization of programs designed to produce desired changes in patient care behaviors.

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Lesson Study in a Turnaround School: Local Knowledge as a Pressure-Balanced Valve for Improved Instruction

Teachers College Record ◽

10.1177/016146811711900605 ◽

2017 ◽

Vol 119 (6) ◽

pp. 1-58

Author(s):

Vicki S. Collet

Keyword(s):

Local Knowledge ◽

Lesson Study ◽

Unique Contribution ◽

High Stakes ◽

Turnaround School ◽

State Accountability ◽

Teachers And Students ◽

Study Process ◽

High Needs Schools ◽

The Impact

Background Federal and state accountability policies attempt to improve educational outcomes but have been blamed for a breadth of ills, including minimizing local knowledge and reducing teachers’ ability to respond to contextual needs. Teachers in high-needs schools, especially, feel the effects of constrained curricula and increased testing, resulting in increased workload and anxiety. Purpose This article explores the impact of professional development on teachers and students in a time of high-stakes accountability. Specifically, we ask: Does Lesson Study impact teachers’ instruction and students’ achievement in writing? And how do pressures imposed by policy impact efficacy and collaboration in a high-needs school? Research Design This study uses data from 20 Lesson Study meetings at a high-needs, “Turnaround” school and considers changes in students’ writing achievement. The mixed-method approach and high-stakes context offer a unique contribution to Lesson Study research. Conclusions Findings indicate that instruction changed and students’ writing significantly improved, with the mean growth percentile increasing from the 30th to the 46th percentile on state assessments. Further, we found that during the Lesson Study process, teachers moved through six Stages of Transformation in response to a high-pressure context, moving from feelings of anger and blame-shifting to eventual feelings of empowerment.

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An Alternative Practice Model: Residents Transform Continuity Clinic and Become Systems Thinkers

Journal of Graduate Medical Education ◽

10.4300/jgme-d-11-00133.1 ◽

2012 ◽

Vol 4 (2) ◽

pp. 232-236 ◽

Cited By ~ 4

Author(s):

Colleen Y. Colbert ◽

John D. Myers ◽

Christian T. Cable ◽

Paul E. Ogden ◽

Curtis Mirkes ◽

...

Keyword(s):

Internal Medicine ◽

Focus Groups ◽

Patient Care ◽

Systems Thinking ◽

Theory Approach ◽

Health Care Environment ◽

Continuity Clinic ◽

Residency Programs ◽

Clinic Efficiency ◽

System Changes

Abstract Background A changing health care environment has created a need for physicians trained in health system improvement. Residency programs have struggled to teach and assess practice-based learning and improvement and systems-based practice competencies, particularly within ambulatory settings. Intervention We describe a resident-created and resident-led quality and practice-improvement council in an internal medicine continuity clinic. We conducted focus groups and report on residents' perspectives on council membership, practice management experiences, quality improvement projects, and resident satisfaction. Method Focus groups were held from May 2009 to March 2010 with internal medicine residents (N = 5/focus group) who participated in the Continuity Clinic Ownership in Resident Education (CCORE) council. Data were analyzed with a grounded theory approach. Results During the focus groups, residents responded to the question: “Do you have any new insights into delivering quality patient care in an outpatient clinic as a result of this experience (CCORE membership)?” The qualitative analysis resulted in 6 themes: systems thinking and systems-based care skills; improving quality of patient care; improved clinic efficiency; ownership of patients; need for improved communication of practice changes; and a springboard for research. Conclusions CCORE residents participated in system changes and acquired leadership skills while working on practice-based and system problems in a clinic microsystem. We believe this model can be implemented by other residency programs to promote the development of systems thinking in residents, increase their ownership of continuity clinic, and empower them to implement system changes.

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Application of the Weed System to Psychiatric Records

Psychiatry in Medicine ◽

10.2190/62vy-dn7e-c1u9-4vtx ◽

1972 ◽

Vol 3 (2) ◽

pp. 119-129 ◽

Cited By ~ 33

Author(s):

Richard L. Grant ◽

Barry M. Maletzky

Keyword(s):

Medical Education ◽

Patient Care ◽

General Hospital ◽

Medical Record ◽

Medical Schools ◽

Medical Chart ◽

Chart Audit ◽

Record Keeping ◽

Teaching Research ◽

Practicing Physicians

The medical record is being called upon to play an increasingly important role in medical education and effective patient care. The Weed system of “problem-oriented” medical record-keeping can enhance the effectiveness of the medical chart for these purposes and also for the various goals of chart audit. There has been increasing acceptance and application of this system both in medical schools and by practicing physicians. The psychiatric record has been particularly lacking in consistent organization, clarity, accuracy and readability. We have combined, in our approach to psychiatric records in a general hospital, a strongly behavioral and social psychiatric perspective with the Weed system to provide a psychiatric record that is a usable and practical document for teaching, research, effective continued patient care, and medical and fiscal audit.

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Unmuting Medical Students’ Education: Utilizing Telemedicine During the COVID-19 Pandemic and Beyond (Preprint)

10.2196/preprints.19667 ◽

2020 ◽

Author(s):

Ariella Magen Iancu ◽

Michael Thomas Kemp ◽

Hasan Badre Alam

Keyword(s):

Medical Education ◽

Medical Students ◽

Patient Care ◽

Core Competencies ◽

Medical Schools ◽

High Quality ◽

Social Distancing ◽

Student Education

UNSTRUCTURED Due to the coronavirus disease (COVID-19) pandemic, medical schools have paused traditional clerkships, eliminating direct patient encounters from medical students’ education for the immediate future. Telemedicine offers opportunities in a variety of specialties that can augment student education during this time. The projected growth of telemedicine necessitates that students learn new skills to be effective providers. In this viewpoint, we delineate specific telehealth opportunities that teach core competencies for patient care, while also teaching telemedicine-specific skills. Schools can further augment student education through a variety of telemedicine initiatives across multiple medical fields. The explosion of telemedicine programs due to the pandemic can be a catalyst for schools to integrate telemedicine into their current curricula. The depth and variety of telemedicine opportunities allow schools to continue providing high-quality medical education while maintaining social distancing policies.

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Libyan Medical Schools Challenges Toward National and Global Accreditation (Preprint)

10.2196/preprints.24641 ◽

2020 ◽

Author(s):

Ahmed Atia

Keyword(s):

Medical Education ◽

Quality Assurance ◽

Education System ◽

Medical Schools ◽

World Federation ◽

The World ◽

Medical Faculties

UNSTRUCTURED Dear Editor, we would like to share the Libyan’s experiences in the accreditation of medical education. We shall first describe in brief the education system in Libya before talking about the process and challenges in accreditation of medical education. Next, we shall clarify the role of the National Center for Quality Assurance and Accreditation (NCQAA) in supporting medical faculties to adopt the criteria of the world federation of medical education (WFME).

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Educational Service and Quality Assurance from the Perception of Teachers and Students during COVID-19 in an Accredited and Certified Administration Degree Program

Global Journal of Management and Business Research ◽

10.34257/gjmbravol21is12pg1 ◽

2022 ◽

pp. 1-11

Author(s):

Jarrin Jaramillo Gladys Fabiola ◽

Zamora Moreta Marina Genoveva ◽

Avila Proaño Leonardo Antonino

Keyword(s):

Quality Assurance ◽

Educational Service ◽

The Sustainable Development ◽

Face To Face ◽

Agenda 2030 ◽

Teachers And Students ◽

The Face ◽

Development Goals ◽

Teaching Learning ◽

The Impact

The impact of the COVID-19 pandemic has evidenced the fragility of the education system at all levels, which is why the call of the United Nations through the Sustainable Development Goals (SDGs), Agenda 2030, specifically Goal 4, is especially relevant. Additionally, Pope Francis, at the end of the year 2020, proposes to the world a Global Pact on Education, in view of the increase of the social debt due to the unprecedented affectation of the educational system. This disruption in the lives of all people due to compulsory isolation gave way to a change of era and surprised the face-to-face education supply, which had to adjust to a new way of educating. The capacity for resilience made it possible to evaluate, analyze and visualize transformation processes in education, whether in the management of the educational service and/or in the teaching-learning systems. Therefore, this work aims to identify the perception of teachers and students regarding the educational service and quality assurance in COVID-19 time, of an accredited and certified Administration career, belonging to a prestigious university in Ecuador with Ignatian educational model, during the year 2020.

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